Journal of the Korean Academy of Child and Adolescent Psychiatry

대한소아청소년정신의학회 (Korean Academy of Child and Adolescent Psychiatry)
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주의력결핍 과잉행동장애 아동과 아스퍼거장애 아동에서 사회기술훈련의 효과 비교

The Effect of Social Skills Training for Children with Attention-Deficit Hyperactivity Disorder and Asperger's Disorder : Preliminary Study

  • 황지희 (제주대학교 의과대학 정신과학교실) ;
  • 곽영숙 (제주대학교 의과대학 소아청소년정신과학교실)
  • Hwang, Ji-Hee (Department of Neuropsychiatry, Jeju National University College of Medicine) ;
  • Kwack, Young-Sook (Division of Child and Adolescent Psychiatry, Jeju National University College of Medicine)
  • 투고 : 2013.06.04
  • 심사 : 2013.09.17
  • 발행 : 2013.12.31
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초록

Objectives : Attention-deficit hyperactivity disorder (ADHD) and Asperger's disorder (AD) in children are associated with attentional problems, impulsivity, hyperactivity, and difficulties with social interactions. Pharmacological treatment may alleviate symptoms of ADHD, but seldom solves difficulties with social interactions. Social skills training (SST) may assist in improving their social interactions. We examined the effects of SST on children's social competences, general behavior, and ADHD symptoms. Methods : Thirty four children, aged 7 to 12 years, participated in the cognitive behavioral SST program once a week at the outpatient division of child-adolescent psychiatry. SST was composed of 24 sessions (ninety minutes) for 6 months. Twenty-five children were diagnosed with ADHD, and 9 children were diagnosed with AD. Parents of the children rated Korea-Child Behavior Checklist (K-CBCL), Conner's rating scales, Korean-ADHD Rating Scale (K-ARS), Social Skill Rating System (SSRS), and Matson's Social Skill Rating Scale as an evaluation of the treatment effect, before the first session and after the final session of the training. Results : The ADHD group showed significantly increased scores of social and social competence of CBCL and SSRS. Further, scores of externalizing problems of CBCL, CRS, and ARS were significantly decreased. The Asperger's group showed significantly increased scores of social competence of CBCL, SSRS, and MESS. There was a significant difference of the improvement in CBCL's school and total behavior problem score, CRS between drug change group and no drug change group. Conclusion : The result of this study suggests that SST is effective in improving social skills for children with ADHD and AD. In addition, SST has shown its effectiveness in treating attentional problems for children with ADHD. To prove objective usefulness of SST, further studies with a more structured design and long-term duration along with a sufficient number of AD participants will be necessary.

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참고문헌

  1. Greenhill LL, Halperin JM, Abikoff H. Stimulant medications. J Am Acad Child Adolesc Psychiatry 1999;38:503-512. https://doi.org/10.1097/00004583-199905000-00011
  2. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. Arch Gen Psychiatry 1999;56:1073-1086. https://doi.org/10.1001/archpsyc.56.12.1073
  3. Pliszka SR, Crismon ML, Hughes CW, Corners CK, Emslie GJ, Jensen PS, et al. The Texas Children’s Medication Algorithm Project: revision of the algorithm for pharmacotherapy of attention-deficit/ hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2006;45:642-657. https://doi.org/10.1097/01.chi.0000215326.51175.eb
  4. Yoo HJ, Yang SJ, Shin D, Kang H, Kim BN, Kim JH, et al. The Korean practice parameter for the treatment of attention-deficit hyperactivity disorder (III): pharmacologic treatment. J Korean Acad Child Adolesc Psychiatry 2007;18:16-25.
  5. Park NS. Effects of methylphenidate treatment on cognitive behavioral symptoms and social, academic & emotional adjustment of ADHD children. Seoul: Yonsei Univ.;1992.
  6. Ha EH. Effects of stimulant medication on the mother-child interaction patterns and cognitive-behavioral symptoms of ADHD children. Korean J Clin Psychology 1992;11:145-160.
  7. Kim SS, Ahn DH, Lee YH. The effects of the combined treatment of medication and parent training in children with attention-deficit/ hyperactivity disorder (ADHD). J Korean Neuropsychiatr Assoc 1998;37:683-699.
  8. Elder JP, Edelstein BA, Narick NM. Adolescent psychiatric patients: modifying aggressive behavior with social skills training. Behav Modif 1979;3:161-178. https://doi.org/10.1177/014544557932002
  9. de Boo GM, Prins PJ. Social incompetence in children with ADHD: possible moderators and mediators in social-skills training. Clin Psychol Rev 2007;27:78-97. https://doi.org/10.1016/j.cpr.2006.03.006
  10. Kolko DJ, Loar LL, Sturnick D. Inpatient social-cognitive skills training groups with conduct disordered and attention deficit disordered children. J Child Psychol Psychiatry 1990;31:737-748. https://doi.org/10.1111/j.1469-7610.1990.tb00814.x
  11. Tutty S, Gephart H, Wurzbacher K. Enhancing behavioral and social skill functioning in children newly diagnosed with attentiondeficit hyperactivity disorder in a pediatric setting. J Dev Behav Pediatr 2003;24:51-57. https://doi.org/10.1097/00004703-200302000-00010
  12. Frankel F, Myatt R, Cantwell DP, Feinberg DT. Parent-assisted transfer of children’s social skills training: effects on children with and without attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 1997;36:1056-1064. https://doi.org/10.1097/00004583-199708000-00013
  13. Myles BS, Simpson RL. Understanding the hidden curriculum: an essential social skill for children and youth with Asperger syndrome. Interv School Clin 2001;36:279-286. https://doi.org/10.1177/105345120103600504
  14. Green J, Gilchrist A, Burton D, Cox A. Social and psychiatric functioning in adolescents with Asperger syndrome compared with conduct disorder. J Autism Dev Disord 2000;30:279-293. https://doi.org/10.1023/A:1005523232106
  15. Scahill L, Martin A. Psychopharmacology. In: Volkmar FR, Klin A, Paul R, Cohen DJ, editors. Handbook of autism and pervasive developmental disorders. Hoboken: Wiley;2005. p.1102-1122.
  16. Barry TD, Klinger LG, Lee JM, Palardy N, Gilmore T, Bodin SD. Examining the effectiveness of an outpatient clinic-based social skills group for high-functioning children with autism. J Autism Dev Disord 2003;33:685-701. https://doi.org/10.1023/B:JADD.0000006004.86556.e0
  17. Tse J, Strulovitch J, Tagalakis V, Meng L, Fombonne E. Social skills training for adolescents with Asperger syndrome and high-functioning autism. J Autism Dev Disord 2007;37:1960-1968. https://doi.org/10.1007/s10803-006-0343-3
  18. Beaumont R, Sofronoff K. A multi-component social skills intervention for children with Asperger syndrome: the Junior Detective Training Program. J Child Psychol Psychiatry 2008;49:743-753. https://doi.org/10.1111/j.1469-7610.2008.01920.x
  19. Lee KS, Hong JE, Shin YJ. Applying the social-cognition improvement program for children with Asperger disorder. Korean J Dev Psychol 2002;15:71-91.
  20. Kim MR. The Effect on Applying of Social Skills Program for Children with Asperger Syndrome. Yongin: Dankook Univ.;2010.
  21. On SG, Shin MS. The effect of social skill training for psychiatric children with social skill deficit. Cog Behav Ther Korea 2007;7:1-16.
  22. Gresham FM, Elliott SN. Social skills rating system. Circle Pines, MN: American Guidance Service;1990.
  23. Han ES, Ahn DH, Lee YH. The social skill training in children with attention-deficit hyperactivity disorder (ADHD). J Korean Acad Child Adolesc Psychiatry 2001;12:79-93.
  24. Tutty S, Gephart H, Wurzbacher K. Enhancing behavioral and social skill functioning in children newly diagnosed with attentiondeficit hyperactivity disorder in a pediatric setting. J Dev Behav Pediatr 2003;24:51-57. https://doi.org/10.1097/00004703-200302000-00010
  25. Frankel F, Myatt R, Cantwell DP, Feinberg DT. Parent-assisted transfer of children’s social skills training: effects on children with and without attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 1997;36:1056-1064. https://doi.org/10.1097/00004583-199708000-00013
  26. Ha EH, O GG, Lee HR, Hong GU. Reconstruction of the Behavior Problem Scales of the Korean CBCL. Seoul J Psychiatry 1995;20:245-253.
  27. DuPaul GJ. Parent and teacher rating of A DHD symptoms: psychometric properties in a community-based sample. J Clin Child Psychol 1991;20:245-253. https://doi.org/10.1207/s15374424jccp2003_3
  28. So YK, Noh JS, Kim YS, Ko SG, Koh YJ. The reliability and validity of orean Parent and Teacher ADHD Rating Scale. J Korean Neuropsychiatr Assoc 2002;41:283-289.
  29. Lee HR, Min SG, Kim YJ, Oh KJ. Characteristics of Attention Deficit-hyper Activity in Touretteʼs Disorder. J Korean Neuropsychiatr Assoc 1988;27:542-547.
  30. Scheres A, Oosterlaan J, Sergeant JA. Response execution and inhibition in children with AD/HD and other disruptive disorders: the role of behavioural activation. J Child Psychol Psychiatry 2001;42:347-357. https://doi.org/10.1111/1469-7610.00728
  31. Park NS, Oh KJ. Effects of methylphenidate treatment on cognitive behavioral symptoms and social, academic & emotional adjustment of ADHD children. Korean J Clin Psychology 1992;11:235-248.
  32. Oh KJ, Min SK, Park JK, Ko RW. Development of cognitive-behavioral treatment for noncompliant and aggressive behavior in children. Korean J Clin Pyschol 1998;17:1-15.
  33. Kim HG. The validation of a SSRS (Social Skill Rating System): the focus of mentally retarded children on elementary students. Korean J Soc Special Educ 1996;17:121-155.
  34. Han ES. The Effects of Social skills training in Children with attention Deficit Hyperactivity Disorder. Seoul: Sungkyunkwan Univ.;2000.
  35. Miranda A, Presentacion MJ. Efficacy of cognitive behavioral therapy in the treatment of children with ADHD, with or without aggressiveness. Psychol School 2000;37:169-182. https://doi.org/10.1002/(SICI)1520-6807(200003)37:2<169::AID-PITS8>3.0.CO;2-8
  36. Park SY, Kwack KY, Kim MK. Effect of the Social Skill Training in ADHD Children. J Korean Acad Child Adolesc Psychiatry 1998;9:154-164.
  37. Antshel KM, Remer R. Social skills training in children with attention deficit hyperactivity disorder: a randomized-controlled clinical trial. J Clin Child Adolesc Psychol 2003;32:153-165. https://doi.org/10.1207/S15374424JCCP3201_14